Simulation of medical procedures is becoming a more prominent part of medical training. Currently, tissue models, such as animal tissue, human cadaveric tissue, or simulated, artificial tissue are used for medical education. Medical students can perform surgical or other medical techniques on the tissue model, and their performance can be evaluated by trainers. Automatic and quantitative analysis of performance can be used because it can permit a student to assess performance without a trainer having to observe the actual procedure and because it permits reliable, repeatable, objective assessment. However, current methods of automatic analysis focus on tracking the instruments used for a procedure, such as with positional sensors mounted to the instruments. While instrument tracking can provide an approximate measure of how well the procedure was done, final performance analysis can still call for inspection by a trainer, such as a proctor. Moreover, instrument tracking can fail to recognize or evaluate the effect on the tissue model, such as tissue tension or tearing.